Important note: Information in this article was accurate in 2003. The state of the art may have changed since the publication date.
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New Vision (Kampala) - September 30, 2003
Sheila B Gashishiri
One of the products is currently being tested in Uganda and other countries. A London-based pharmaceutical company Indevus Pharmaceuticals, has already announced the start of a second phase of clinical trials of microbicides in Kampala to assess the safety of a microbicide being tested in Uganda which has been code-named PRO 2000.
A report published in a London gazette Women's Health Weekly shows that the clinical trial is targeting approximately 100 sexually active female volunteers to be treated for a month. The trials are being spearheaded by the Imperial College in London with the joint involvement of the Uganda Virus Research Institute, St Francis Hospital Nsambya and Mulago Hospital.
The campaign for microbicides is being spearheaded by the Society African Women Against Aids and they recently met at Hotel Africana to deliberate on several issues including accessibility and the cost of microbicides.
What are microbicides?
The term microbicide refers to a range of different products that share one common characteristic to prevent the spread of HIV and other sexually transmitted diseases. The substance is applied topically to the vagina or rectum to kill germs and safe guard the woman from infection.
A microbicide could be produced in many forms, including gels, creams, suppositories, films, lubricants, or in the form of a sponge ring that slowly releases the active ingredient. It will be useful for women whose partners cannot or will not use condoms as it is a woman initiated and controlled method of protection against HIV/AIDS. Future microbicides will be available and affordable to the average Ugandan woman. There will be non-contraceptive microbicides and dual microbicides that prevent HIV and allow pregnancies or do both hence women who want to conceive can protect their health.
Many women have less or no social-economical power to prevent the transmission of HIV and other STDs, but with a microbicide a woman can apply it without the knowledge of her sex partner.
Where can they be obtained?
The microbicides are not yet available world over because there are no safe microbicides as yet. There are 60 products under test, but only 11 have been proven to be safe in animals. They have not yet passed the test to see if they can protect human beings from HIV infection. However, if the research is successful they will be available in the next five to seven years.
How do microbicides operate or work?
A microbicide will prevent HIV and STIs by killing or otherwise immobilising pathogens, block infection by creating a barrier between the pathogens and the cells of the vagina or rectum and also prevent the infection from taking hold after it has entered the body. Ideally, a microbicide would combine these mechanisms for extra effectiveness.
Will they eliminate the use of condoms?
Definitely not because they are not supplementing condom use. Condoms still provide better protection and remain a better option.
Will microbicides stop the transmission of all STDs?
Microbicides may not stop the transmission of all STDs because STDs are caused by different pathogens that need different drugs to deal with each one of them independently.
The products so far tested can only prevent the transmission of HIV and one other STD.
Will the microbicides be safe and reliable?
Dr. Kaddu Mulindwa of Mulago says that any new products on the market must under go a thorough, rigorous safety measure. "The women health activists and research workers are working hand in hand to see that the microbicides are thorough and clinically produced for effective positive use."
One other challenge that activists foresee in the use or application of microbicides is the fact that they are controlled by the woman. In most African communities women do not have full control over their bodies and in many cases, men go against their will to force them into unprotected sex and unwanted pregnancies.
Will men benefit from them?
Male partners would also be protected against HIV and any other STDs. However homosexuals will not benefit from these microbicides because they can only be applied in the vagina.
Do we really need them?
Yes we do. As researchers are in the process of manufacturing a vaccine, it is also necessary to exploit other cheaper options that can be readily available along side those already in place in order to fight the epidemic
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