Low-cost, low-profile legislation in a hyped-up
election year could change the course of the epidemic -- and improve
your sex life! Anna Forbes just says yes.
Tonight, you or someone you know may have sex without
a condom. Maybe you'll decide it's not worth pissing off your husband
to bring it up. Maybe you'll want someone so bad you just won't want to
risk the rejection. Or maybe you'll want someone so bad, period. Every
day, in thousands of places, women and men are getting infected (or reinfected)
because they can't or don't use a condom.
Spending more money on prevention education is
the usual prescription -- and it can't hurt. But we can lower the odds
of HIV infection even without upping condom use. We could have safe,
effective vaginal and rectal HIV killers in the near future if we care
enough to kick up a fuss.
Microbicides -- creams or gels applied topically
to reduce the risk of infection during sex -- aren't "pie in the sky"
anymore. Of the more than 60 potential products, half are already in,
or on the verge of, human trials. The Global Campaign for STI/HIV Prevention
Alternatives for Women, an international coalition of microbicide advocates,
estimates that just $75 to $100 million a year for the next five years
would move one or more of these products through the pipeline and on
But the money isn't there. Right now $35 million
a year at most is being spent globally on microbicide research. This
underfunding means potentially effective microbicides will sit on lab
shelves, going nowhere fast because their developers (small, often university-based
research groups) simply can't afford to test them.
The problem is that the pharmaceutical conglomerates
that support most AIDS research do not yet perceive microbicides as
profitable. Wake up! Several microbicides-in-waiting could be safe,
effective against HIV without a condom, unobtrusive enough to use without
a partner's knowledge, and inexpensive. Some may block HIV but allow
conception. Others may be bidirectional, disabling the virus in an HIV
positive woman's vaginal secretions and thus enabling her to protect
her partner from infection -- as well as herself from reinfection. A
number in the pipeline will probably be appropriate for rectal use,
though it will take some agitation to break the not-so-polite silence
surrounding this topic. With so many promising leads, research in this
area should be racing forward. Instead, it's close to stalling.
Big Pharma shells out most of the $56 billion
spent per year worldwide on health research. To them, the $100 million
needed for microbicides is pocket change. But rather than invest now,
they are waiting for publicly and philanthropically funded research
to yield products with proven effectiveness and, in the words of Alan
Stone, MD, of the British Medical Research Council, "convincing evidence
This leaves the microbicide research engine running
mainly on the $25 million a year supplied by the U.S. government --
1 percent of the feds' AIDS research budget. The Microbicides Development
Act of 2000 proposes to correct this. Written by microbicide activists
and supportive House staff, the bill increases microbicide research
funding at the National Institutes of Health (NIH) to $50 million in
2001, $75 million in 2002 and $100 million in 2003 -- enough to grease
the pipeline for the first microbicides.
The House version of the Act, H.R. 3891, was
introduced by Reps. Connie Morella (R-MD) and Nancy Pelosi (D-CA) last
March and assigned to the House Commerce Committee's Subcommittee on
Health and the Environment. It has gained the support of both the Congressional
Women's Caucus and the Congressional Black Caucus. Tragically, no one
has yet stepped forward to introduce the Senate version. Even the House
version has only 25 cosponsors as of this writing -- too few to guarantee
passage. Morella introduced micro-bicide funding bills in the two previous
Congresses, and both times they died in committee due to lack of support.
Noncontroversial and low budget, this bill deserves
the support of Congress members on both sides of the aisle. But few
can even tell the difference between microbicides and microwaves. We
can change that. If AIDS activists make the Microbicides Development
Act a high priority between now and late December, we can force their
hands. Otherwise, the bill will die in committee again, delaying access
to microbicides by a few more years. So call your senators and rep,
and tell them to sign on to the Microbicides Development Act of 2000.
It's time to make a fuss. Silence still equals death.
To reach your senator or rep by phone, call
800.648.3516. For info, or to sign a petition calling for more microbicide
research, contact the Global Campaign for STI/HIV Prevention Alternatives
for Women at 301.270.1182 or http://www.genderhealth.org/.