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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The New York Times - Tuesday, April 1, 2003
Stephanie Strom
The Bill and Melinda Gates Foundation announced yesterday that it would give $60 million to the International Partnership for Microbicides, a nonprofit organization dedicated to speeding the development and distribution of topical means of preventing H.I.V. transmission like foams or gels.
The grant is the largest ever for microbicide research and development, and together with previous support from the Rockefeller Foundation and Britain, Denmark, Ireland, the Netherlands and Norway, the partnership, founded last year, now has $100 million.
The partnership has said that $500 million will be needed to bring a microbicide to market. Zeda Rosenberg, chief executive of the partnership, said it now had "a meaningful down payment" toward development of an affordable drug to prevent transmission during sexual intercourse of the virus that causes AIDS.
"Several products are languishing at different stages of the development pipeline," Dr. Rosenberg said, "and a limiting factor in all cases is money."
Development of microbicides to block H.I.V. transmission is likely to fall in large part to nonprofit groups, experts say, because microbicides, which fight transmission in a variety of ways, will be of most use to poor women in sub-Saharan Africa, a market that offers little profit potential to drug companies.
About 90 percent of the roughly 5,000 women around the world infected daily with H.I.V. live in that region, said Dr. Quarraisha Abdool Karim, an epidemiologist who has studied the evolution of the AIDS epidemic in the area and who is on the board of the partnership. Dr. Karim said that per capita income in the region was less than $200 a year and that governments there typically spent less than $5 a person annually to subsidize health care.
Experts say those statistics may explain why the private sector has shown little interest in bringing a microbicide to market.
Dr. Helene D. Gayle, director of the H.I.V., tuberculosis and reproductive health program at the Gates Foundation, said that several microbicides nearing the last stage of clinical trials were inexpensive to manufacture, but that the applicators needed to administer them could bring their costs to as much as 50 cents a dose.
"What would be affordable would be pennies a dose," Dr. Gayle said.
The partnership plans to underwrite not only development of the drugs but also of their delivery mechanisms, Dr. Rosenberg said.
Dr. Gayle said it would likely be 2010 before the first microbicides were available.
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