Microbicides:
New Hope for
Prevention
of HIV and
other STIs
Your name here
www.global-campaign.org
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What is a Microbicide?
First Generation:
• Gels and creams
In the future:
• Sponges, vaginal rings
• Gels with barrier devices
© Salam Dahbor, Courtesy Doubleshots Studio
A substance that can reduce the transmission of HIV
and other STI pathogens when applied vaginally and,
possibly, rectally. They are not yet available.
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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
• Could also be used for anal intercourse
• Could also be used by people living with
HIV/AIDS
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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.”
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Comprehensive Strategies for
Protection
Social
Power
Protection
Technology
Economic
Opportunities
Source: Brady, Martha. Population Council, Conceptual Framework. 2005.
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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
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1. boosts vagina’s
natural defenses
4. anti-retrovirals
2. surfactants
3. entry inhibitors
Source: Shattock, R.; Moore, J. Inhibiting Sexual Transmission of HIV-1 Infection. Nature Reviews Microbiology. Vol 1, October 2003.
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The Product Pipeline in 2007
3 products
3 products
30+ products
Laboratory
Testing
2-6 Years
4 products
Phase I
(safety)
Phase II
(safety)
Phase III
(efficacy)
1 to 6
Months
Up to 2
Years
2 to 4
Years
25 – 40
people
200-400
people
3,000-10,000
people
Simultaneous studies in some cases:
HIV+, penile & rectal safety
10 or more years
Source: Alliance Pipeline Update, first week of every month - http://www.microbicide.org/publications
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When can we expect a
microbicide?
• Earliest results from current Phase III trials in
2008-2009
• 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
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Public Funding is Essential
Why aren’t large
pharmaceutical
companies
investing?
– Perceived low
profitability
– Liability concerns
– Lack of in-house
expertise
– Uncertain regulatory
environment
Global Annual Microbicide
R&D Investment 2005
Philanthropic Sector, 13%
US $142.3 million
Public Sector, 87%
US $21.2 million
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The Global Campaign for
Microbicides works to:
• 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
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What You Can Do
Visit www.global-campaign.org…
• Get in touch with local advocates
• Sign up for GC News
• Write to your public officials!
• Endorse the Global Campaign
• Educate others:
– Presentations – Newsletters
– Use our film
– Events
– Fact sheets
– Web-links
www.global-campaign.org
Frank Herholdt, Courtesy of Microbicide Development Project
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
www.global-campaign.org
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Topical Microbicides: New Hope for STI/HIV Prevention