Important note: Information in this article was accurate in 2002. The state of the art may have changed since the publication date.
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San Francisco Examiner - December 3, 2002
Pam Norick And Polly Harrison, Special to The Examiner
Notwithstanding this stark warning, Congress adjourned with little to say on the issue, and allowed the Leadership Against HIV/AIDS, Tuberculosis and Malaria Act to die. This bill, a version of which had passed the House and Senate, represented one of the first times Congress attempted to address the global HIV epidemic.
But final action on the bill was never taken, and the opportunity for the U.S. government to institute a coordinated federal approach to tackling the global HIV/AIDS crisis was squandered.
According to recent United Nations reports, AIDS continues to kill more people worldwide than any other infectious disease. The human and economic costs are staggering. China could have more than 10 million HIV-infected people by 2010. Infection rates in Russia and Eastern Europe are rising faster than anywhere else. India may soon have the largest number of people living with HIV/AIDS in the world. And Sub-Saharan Africa remains devastated by an epidemic that has lowered life expectancy from 62 years on average to just 47. In hard-hit countries like Botswana, where 45 percent of women attending prenatal clinics are HIV-positive, a 15-year old youth has an 80 percent chance of dying of AIDS.
Little attention is paid to the reality that the face of the HIV epidemic both at home and abroad is increasingly female. In Sub-Saharan Africa, 55 percent of those with HIV are women. Young girls in Africa are five times more likely to be infected than boys, with almost 25 percent of 15- to 19-year-old girls in some parts of Sub-Saharan Africa now infected. In Washington, D.C., one in three people with HIV now is a woman.
Biologically, women are four times more vulnerable to HIV infection. Their vulnerability increases due to their lack of economic and social power in many societies, where women often cannot control sexual encounters or insist on protective measures such as abstinence, condom use, or mutual monogamy.
The typical woman who gets infected with HIV has only one partner -- her husband. This trend devastates families and puts unborn children at risk.
The good news is we have within our grasp a technological innovation that could help level the playing field: microbicides. Microbicides are a class of products under development that would be applied topically (like a gel or foam) to prevent the transmission of HIV and other sexually transmitted infections. More than 60 potential microbicides are being researched at public and private research institutes around the world. Many researchers believe that with increased funding and coordination, a microbicide could be available to the public in five years.
While female-controlled prevention methods such as microbicides are increasingly recognized as vital to controlling the spread of HIV, this technology remains the poor stepchild of HIV prevention strategies.
With 15,000 new HIV infections occurring globally each day, and with leading scientists concluding that a vaccine is at least a decade away, new prevention strategies such as microbicides are desperately needed. The law that died with the 107th Congress contained important provisions to support and accelerate microbicide research and development, in addition to significant measures related to care, treatment and HIV vaccine development.
With that opportunity lost, responsibility falls to the next session of Congress.
Comment: letters@examiner.com
Pam Norick is a consultant and serves as senior policy and legislative adviser to the Alliance for Microbicide Development and the Global Campaign for Microbicides. Dr. Polly Harrison is Director of the Alliance for Microbicide Development.
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