Do Microbicides hold the answer to many women’s dilemmas?
Gloria Katusiime (Adopted and edited from Pamoja News). October 8, 2003

‘If scientists have made a spaceship, why have they not developed a substance that is female controlled that can protect women from the HIV virus? The question posed by a Ugandan delegate echoed the frustrations of millions of women desperate for access to female controlled methods.

Pamela Miheso is a 30-year-old rural Kenyan living with HIV.

‘While I was engaged to marry my late husband I got pregnant and miscarried twins. I did not know I was infected, as I was not attending the antenatal clinic. I still went on and got married to my boyfriend I got pregnant again and this time went to an antenatal clinic and tested positive in 1997.
My husband died two years later’.

Miheso laments that many married women are not empowered to negotiate for safer sex. ‘But you know marriage is for good and for worse… After marriage some men expect you to offer sex whether they are faithful or not’ she says.

At the Tuesday Plenary Session of the XIII International Conference on AIDS and STIs in Africa held in Nairobi, Mark Wainberg of the McGill University AIDS Center advocated for female controlled methods, particularly in countries where antiretrovirals drugs were not widely available.

‘Microbicides substances would substantially reduce the likelihood of transmission of sexually transmitted diseases’ he said.

However, Wainberg was also quick to point out that Several Nonoxynol-9 microbicide randomized, placebo controlled trials have failed to protect against HIV infection which means that no more large scale clinical trials with products that lack a clear rationale for microbicide development can be started.

Wainberg also argued that the failed trial showed that work on substances that simultaneously target all STD’s must stop and instead work with molecules that can act in a highly specific and scientifically verifiable way to prevent HIV infection.

He further stressed that the hard reality was that most pharmaceutical companies would not become seriously involved in microbicide research.

‘There will not be an expectation to simply give away a microbicide product that has been shown to be effective because the majority of women in need cannot afford it. Reasonable expectations of profit will, in fact, be present as a consequence of successful product development’ he said.

Wainberg therefore suggested that the international agencies should play a greater role in enabling developing countries become involved in the development of vaccines and microbicides by ensuring the affordability of relevant medical devices.

The World Bank has reportedly committed to both the purchase and distribution of any successful microbicide product.

Wainberg finally dropped the bombshell idea of using antiretrovirals to prevent sexual transmission of HIV-1 in populations at risk like female sex workers and male migrant workers.

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Last update: October-23, 2003