This post is by the Global Center’s David Bryden, who is attending the 2010 International Microbicides Conference this week in Pittsburgh. Stay tuned for more coverage of this important conference.
An exciting conference on microbicides for HIV prevention has gotten underway in Pittsburgh, Penn. There is an air of anticipation at the meeting because some of the most promising clinical trials of microbicides are due to report results soon, such as the CAPRISA study with findings expected on July 21 in at the AIDS conference in Vienna. If this study demonstrates a high degree of effectiveness, it will make headlines around the world and could reshape global health advocacy.
A key theme of the conference, appropriately enough for Pennsylvania’s “City of Bridges,” is achieving faster results by building strong connections between scientific disciplines and affected communities, so that studies of these products — such as vaginal or rectal gels, vaginal rings and other methods to prevent infection — can be even more successful. The 1,000 people in attendance, from 47 countries, have the beautiful view from the balcony of the conference center of the bridges across the river here to remind them of this theme.
At the opening ceremony, Dr. Sharon Hillier, of the University of Pittsburgh, compared the development of microbicides to the successful development of the polio vaccine by Dr. Jonas Salk, right here in Pittsburgh. That required the use of 200,000 lay volunteers who helped out at trial sites, plus the involvement of 60,000 health care personnel and 64,000 teachers. She said that microbicide researchers should take inspiration from the polio effort, in particular from its determination, focus, and use of community support. “We will get there!” she said. “We will eradicate HIV, and what a beautiful dream that will be.”
Dr. Ian McGowan, of the University of Pittsburgh, stressed that the latest figures on the rate of infection demonstrate the urgency of developing new prevention methods. He said young African-American men in Baltimore face an annual HIV incidence rate of 10%. He also said that the needs of men who have sex with men (MSM) are at the forefront, given the deplorable court verdict in Malawi condemning a gay couple to 14 years of hard labor. MSM in Senegal and Ghana face an HIV incidence rate of over 20% and in Nigeria and Kenya of over 10%.
Sunday’s opening plenary brought together scientific and community perspectives. Nono Eland of the Treatment Action Campaign (TAC) took off her outfit to reveal a soccer jersey in recognition of the upcoming World Cup in her home country of South Africa, and she said that a microbicide would be like a good goalie who prevents the ball from getting into the soccer net. She said TAC consistently campaigns for prevention as it mobilizes for treatment, and she expressed concern that funding cuts in the fight against AIDS will threaten prevention.
She said that community awareness of the importance of microbicide research is still far too low. She recounted a meeting she attended of the gender committee of a major union in South Africa where people where clearly not aware of the research underway there. A major problem she said is that people are skeptical that innovations would ever reach them. She recounted one woman asking her about the AIDS vaccine, saying “I do not have access to the HPV vaccine, which already exists, so how would I ever gain access to an AIDS vaccine?”
Eland also emphasized the need for a strong partnership with advocates to get innovations to the field, and she said “science without activism can only go so far.”
Dr. Robin Shattock of the University of London said it was concerning that there were only three microbicide trials underway. He said there was still insufficient lobbying for support for this research. The lack of funding has forced researchers to prioritize, considering potency, selectivity, potential for combination (e.g. with contraceptives), and stage of development. He sketched out some of the questions facing researchers, such as how much of the microbicide is needed, exactly where in the body and how to maximize continued, proper use of the product (i.e., adherence).
Check back here at this blog for more reports from the meeting! You can also find more info at the conference website here: http://www.microbicides2010.org/