Speaking Out

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Tue Sep 7, 2010

AIDS Prevention Gel Research Held Up for Lack of Money

By Sohaila Abdulali

July brought universal rejoicing with the results of CAPRISA 004, the research study that showed for the first time that a vaginal microbicidal gel works to prevent HIV transmission. September brings the sobering news that the next steps towards a product that could save millions of lives, and transform women’s choices, are in jeopardy because of lack of money.

The CAPRISA study, funded jointly by the US and South African governments, showed that women who used a 1% solution of the AIDS treatment drug tenofovir showed a 39% reduction in HIV transmission over those who used a placebo. For those who used the gel exactly as prescribed (up to 12 hours before and as soon as possible up to 12 hours after intercourse) the results shot up to 54%. Not only is this a truly promising lead in preventing HIV, but as an added bonus it is controlled by women, who often cannot opt for safer sex.

In order for the gel to be further tested and ready to be used by women from Andorra to Zambia, at least two further research studies are needed, according to scientists. Six research centers in South Africa are considering carrying out these studies, which would cost about $100 million. So far only $58 million has been pledged, again mostly by the US and South African governments.

The two studies would help determine the efficacy of making the gel available to women. One would expand the age group to include younger sexually active women (16 and 17 years old) and the other would check to see whether just one application of the gel could be effective in blocking HIV. This would make a huge difference to cost and ease of use. In a world where, according to UNAIDS, 7,400 people contract the virus every day, every minute of delay literally means the difference between life and death.

On grounds of economy as well as humanity, it makes perfect sense to fund this research. It will cost millions, whereas treatment for people who contract HIV due to lack of access to prevention would cost billions.

What is $42 million worth? Private security company has to pay the US State Department exactly $42 million for its many violations of US law. The New York Mets will pay $42 million to baseball player Bobby Bonilla, who is retired and will not be hitting a single ball to earn it. Nobody is suggesting that Blackwater or Bonilla pay for microbicide research (although there is a certain poetic flair to the possibility). But the fact remains that $42 million is not much money when so many lives are at stake. 

The global recession and a general pullback from AIDS-related funding are not sufficiently robust reasons for justifying the lack of funding. Somewhere in the treasuries of the rich world, $42 million must exist to take tenofovir gel to the next level. The return on investment promises to be astounding, and the results of losing momentum tragic.